CLINICAL SPECULATION - IS SPECIFICITY BACK - THIS TIME THROMBOANGIITIS-OBLITERANS

Do men with thrombangiitis obliterans (TO) show conspicuous personalit y features and behavior? Twenty-one men with TO were compared with 20 men with coronary artery disease (CAD). All diagnoses were angiographi cally confirmed. Mean ages were 40.1 (TO) and 43.4 years (CAD). Semist ructured, open-ended interviews were conducted. Interview-behavior: TO s were more hostile, minimizing, evasive, and complicated than CADs (p < .001). The interviewer reacted with more anger, impatience, boredom , astonishment, and less empathy towards TOs (p < .001). Adult behavio r: TOs had changed their place of work more often (p < .001), had more absentism from work (p < .001), and had more debts (p = .01) unrelate d to the present illness. They smoked more before the illness (p = .01 ) and continued to smoke more frequently during their illness than CAD s (p < .003). They were more often single or divorced (p < .05) and ha d more conflicts in their relationships (p < .001) than CADs. During c onflicts, TOs more often shouted or withdrew and less frequently tried to resolve conflicts with humor and discussions (p < .001) than CADs. TOs were more frequently dissatisfied with their life situation than CADs (p < .001). TOs more often passively submitted to their illness t han CADs, who tried to cope by giving up smoking and by exercising (p < .001). Childhood: TOs more often mentioned a bad relationship with t heir father than CADs (p = .01) and had more disciplinary problems at home and in school (p = .002). TOs show remarkable personality feature s. They have cell-bound antibodies (to type I and III collagen) and a proneness to HLA-AS and B5, so the question arises as to whether TO pr esents another so called ''psychosomatic'' disorder.